Provider Demographics
NPI:1912743303
Name:DIRECT BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:DIRECT BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:ZEF
Authorized Official - Last Name:DUSI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:203-544-3867
Mailing Address - Street 1:95 GLEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2424
Mailing Address - Country:US
Mailing Address - Phone:203-544-3867
Mailing Address - Fax:203-621-6234
Practice Address - Street 1:95 GLEN HILL RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2424
Practice Address - Country:US
Practice Address - Phone:203-544-3867
Practice Address - Fax:203-621-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty